|
1
|
Zhu Y, Bloxham CJ, Hulme KD, Sinclair JE, Tong ZWM, Steele LE, Noye EC, Lu J, Xia Y, Chew KY, Pickering J, Gilks C, Bowen AC, Short KR. A Meta-analysis on the Role of Children in Severe Acute Respiratory Syndrome Coronavirus 2 in Household Transmission Clusters. Clin Infect Dis 2021; 72:e1146-e1153. [PMID: 33283240 PMCID: PMC7799195 DOI: 10.1093/cid/ciaa1825] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Indexed: 01/19/2023] Open
Abstract
The role of children in the spread of SARS-CoV-2 remains highly controversial. To address this issue, we performed a meta-analysis of the published literature on household SARS-CoV-2 transmission clusters (n=213 from 12 countries). Only 8 (3.8%) transmission clusters were identified as having a paediatric index case. Asymptomatic index cases were associated with a lower secondary attack in contacts than symptomatic index cases (estimate risk ratio [RR], 0.17; 95% confidence interval [CI], 0.09-0.29). To determine the susceptibility of children to household infections the secondary attack rate (SAR) in paediatric household contacts was assessed. The secondary attack rate in paediatric household contacts was lower than in adult household contacts (RR, 0.62; 95% CI, 0.42-0.91). These data have important implications for the ongoing management of the COVID-19 pandemic, including potential vaccine prioritization strategies.
Collapse
Affiliation(s)
- Yanshan Zhu
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Conor J Bloxham
- School of Biomedical Science, The University of Queensland, Brisbane, Australia
| | - Katina D Hulme
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Jane E Sinclair
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Zhen Wei Marcus Tong
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Lauren E Steele
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Ellesandra C Noye
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Jiahai Lu
- One Health Center of Excellence for Research and Training, Department of epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yao Xia
- School of Science, Edith Cowan University, Australia; School of Biomedical Science, The University of Western Australia, Perth, Australia
| | - Keng Yih Chew
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Janessa Pickering
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Western Australia
| | - Charles Gilks
- School of Public Health, The University of Queensland, Brisbane, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
| | - Asha C Bowen
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Western Australia.,Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Perth, Western Australia
| | - Kirsty R Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia.,Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
| |
Collapse
|
|
2
|
Mobility and COVID-19 mortality across Scandinavia: A modeling study. Travel Med Infect Dis 2021; 41:102039. [PMID: 33785456 PMCID: PMC7999697 DOI: 10.1016/j.tmaid.2021.102039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 02/08/2023]
Abstract
Background In response to COVID-19, the Swedish government imposed few travel and mobility restrictions. This contrasted with its Scandinavian neighbours which implemented stringent restrictions. The influence these different approaches had on mobility, and thus on COVID-19 mortality was investigated. Methods Datasets indicating restriction severity and community mobility were examined; Google's ‘Community Movement Reports' (CMR) show activity at key location categories; the Oxford COVID-19 Government Response Tracker collates legislative restrictions into a ‘Stringency Index’ (SI). Results CMR mobility categories were negatively correlated with COVID-19 mortality. The strongest correlations were obtained by negatively time lagging mortality data, suggesting restrictions had a delayed influence. During the ‘first wave’ a model using SI (AIC 632.87) proved favorable to one using contemporaneous CMR data and SI (AIC 1193.84), or lagged CMR data and SI (AIC 642.35). Validation using ‘second wave’ data confirmed this; the model using SI solely again being optimal (RMSE: 0.2486 vs. 0.522 and 104.62). Cross-country differences were apparent in all models; Swedish data, independent of SI and CMR, proved significant throughout. There was a significant association for Sweden and the death number across models. Conclusion SI may provide a broader, more accurate, representation of changes in movement in response to COVID-19 restrictions.
Collapse
|